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Healing River Chiropractic in Stillwater

Dr. Kellie Seth, D.C.

Restoring Your Health Naturally

As new patients to Healing River Chiropractic, you will be asked to fill out new patient forms.

For your convenience, we have attached the forms you will be asked to complete and sign when you arrive for your first appointment. You may print these forms and complete them in advance if you like. Doing so will save time and paperwork for you on the day of your appointment.

  1. The first form is the Patient Intake Form, this form will need to be completed, signed and dated.
  2. The second form is Patient Health Questionaaire (PHQ) Form , this form needs to be completed, signed and dated.
  3. The third form is the standard Privacy and Practices Form. 

                Complete HIPPA document  This is the complete HIPPA document for reference. You do not need to print this out.

            Privacy Practices Release Form  - requires signature and must be dated from all patients.

If you have questions about the forms, leave the areas in question blank. We will go over the forms with you in detail when you arrive for your appointment.

For your privacy, we ask that you do not complete these forms on-line.